Many women do not realize that a significant decline in fertility begins in the early 30's. In fact, for many successful fertility treatments, the predominate predictor of pregnancy outcome is the age of the female partner. The significant impact that age has on fertility is related to both the quality and quantity of a woman's eggs.
Women are born with all the eggs that they will ever have. As such, the ovary can be generally thought of as an egg bank from which a woman withdraws during her reproductive life. Each month one egg or more is released during ovulation, but about one thousand additional eggs are lost by follicular atresia. Thus, with advanced maternal age the number of eggs that can be successfully recruited for a possible pregnancy declines.
In addition to this decrease in the number of eggs that women experience, some women may have poor quality eggs that reduce the likelihood that a given fertility treatment will result in a healthy pregnancy. Ovarian reserve screening is one mechanism by which fertility specialists can partially predict the reproductive potential of a specific patient as well as the potential of her eggs to result in a healthy pregnancy. Ovarian reserve is the term typically used to define the capacity of the ovary to provide eggs that are capable of fertilization. As such, the determination of a woman's ovarian reserve is an important aspect in the management and treatment of infertility.
Assessing ovarian reserve is routinely conducted for determining infertility in women of advanced reproductive age. One of the key indicators to determine the reproductive potential in women is the basal Follicle Stimulating Hormone (FSH) level on days 2-5 of the menstrual cycle. Elevated FSH at the early follicular phase is indicative of diminished ovarian reserve. Currently, the most common test for assessing ovarian reserve is the day 3 FSH test. This blood test determines the level of FSH on cycle day 3. Cycle day 3 is chosen because at this time the estrogen level is expected to be low, a critical feature, as FSH levels are subject to a negative feedback. Generally FSH levels are expected to be below 10 mIU/ml in women with reproductive potential (e.g., levels of 10-15 mIU/ml are considered borderline).
While measuring serum FSH is still the standard practice and widely adopted in fertility clinics, such testing is not well suited for home use by an individual. As such, there remains a need for a reliable and more convenient and cost effective diagnostic test for home use, such as an over the counter test.